BOOK
Recognizing and Treating Breathing Disorders E-Book
Leon Chaitow | Chris Gilbert | Dinah Morrison
(2014)
Additional Information
Book Details
Abstract
This authoritative, research-based book, written by a team of clinical experts, offers an introduction to the symptoms and causes of disordered breathing as well as the strategies and protocols that can be used to correct and restore normal breathing. Multidisciplinary Approaches to Breathing Pattern Disorders guides readers through a discussion of the current research that links disordered breathing patterns with perceived pain levels, fatigue, stress and anxiety. Basic mechanics, physiology, and biochemistry of normal breathing are outlined to lay a foundation for understanding causes and mechanics of disordered breathing. Self-help strategies with charts and workbook pages that may be photocopied as handouts are designed to help patients overcome specific breathing problems.
"...this second edition is particularly outstanding, providing a good basis of practical hands-on techniques, well supported by pictures and the website, and giving specific focus on sports, speech and chronic pain." Reviewed by Janet Rowley on behalf of the New Zealand Journal of Physiotherapy, January 2015
"..a fantastic resource which will help students, clinicians, and physiotherapists to carry out effective evaluation and treatment in an acute care setting." Reviewed by Poonam Mehta on behalf of the New Zealand Journal of Physiotherapy, January 2015
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Recognizing and Treating Breathing Disorders | i | ||
| Copyright page | iv | ||
| Table of Contents | v | ||
| Contributors | vii | ||
| Foreword | ix | ||
| Preface | xi | ||
| Reference | xii | ||
| Acknowledgments | xiii | ||
| Disclaimer | xv | ||
| The Website | xvii | ||
| Glossary/ Acronyms/Abbreviations | xix | ||
| 1 What are breathing pattern disorders? | 1 | ||
| Chapter contents | 1 | ||
| Historical background to the extreme of BPD/hyperventilation | 1 | ||
| Varieties of BPD and its symptoms | 2 | ||
| How common is HVS, and who is most affected? | 3 | ||
| BPD is not a disease | 4 | ||
| ‘The Great Mimic’ | 4 | ||
| Lum’s perspective | 4 | ||
| Adaptation | 5 | ||
| How well is the individual adapting? | 6 | ||
| Has adaptation reached the point of exhaustion? | 7 | ||
| Biological rhythms as a guide | 7 | ||
| Evidence of functional change with treatment | 7 | ||
| Patient categorization | 8 | ||
| Homeostasis and heterostasis | 8 | ||
| Therapy as a stress factor | 8 | ||
| Conclusion | 9 | ||
| Where next? | 9 | ||
| References | 9 | ||
| 2.1 Dynamic Neuromuscular Stabilization: | 11 | ||
| Chapter contents | 11 | ||
| Diaphragm function from a developmental perspective | 12 | ||
| Definition of an ideal respiratory pattern from a developmental perspective | 13 | ||
| Posture and postural function of the diaphragm | 15 | ||
| Pathological respiratory postural pattern | 19 | ||
| Visceral and sphincter functions of the diaphragm | 20 | ||
| Pressure activity of the diaphragm and the effect on internal organ function | 20 | ||
| Visceral movement and peristalsis | 20 | ||
| Birth | 20 | ||
| Defecation | 20 | ||
| Vomiting | 20 | ||
| The diaphragm’s role as a lower esophageal sphincter | 20 | ||
| References | 21 | ||
| 2.2 The structure and function of breathing | 23 | ||
| Chapter contents | 23 | ||
| The structure–function continuum | 23 | ||
| Multiple influences: biomechanical, biochemical and psychological | 24 | ||
| Objectives and methods | 24 | ||
| The upper airway | 25 | ||
| The nose | 25 | ||
| Pathological states affecting the airways | 25 | ||
| Postural considerations | 25 | ||
| Is there such a thing as an optimal breathing pattern? | 25 | ||
| Is there an ideal posture? | 26 | ||
| Janda’s crossed syndromes (Janda 1983) | 26 | ||
| Upper crossed syndrome (Fig. 2.2.1) | 26 | ||
| Posture and breathing | 27 | ||
| Further structural considerations | 29 | ||
| The thoracic cylinder | 30 | ||
| Lung volume, intra-abdominal pressure and back pain | 30 | ||
| The biomechanics of breathing | 30 | ||
| The muscles of respiration | 34 | ||
| Role of intercostal musculature | 35 | ||
| Additional muscular and fascial influences and connections | 35 | ||
| Thoracic spine and ribs | 36 | ||
| Facet orientation | 37 | ||
| Discs | 38 | ||
| Structural features of the ribs (see Fig. 2.2.10) | 38 | ||
| Atypical ribs | 38 | ||
| Structural features of the sternum (see Figs 2.2.10 and 2.2.12) | 38 | ||
| Posterior thorax | 38 | ||
| Neural regulation of breathing | 38 | ||
| Chemical control of breathing | 39 | ||
| Voluntary and neural control of breathing | 39 | ||
| NANC system | 40 | ||
| Where next? | 40 | ||
| References | 41 | ||
| 2.3 Nasal influences on breathing | 45 | ||
| Chapter contents | 45 | ||
| Introduction | 45 | ||
| Nasal anatomy and physiology | 45 | ||
| Nasal resistance | 46 | ||
| Smell and the limbic system | 47 | ||
| Lower respiratory tract disease | 47 | ||
| Nasal history taking | 47 | ||
| Nasal examination | 48 | ||
| Teaching nasal breathing | 48 | ||
| Nasal saline irrigation | 49 | ||
| Conclusions | 49 | ||
| References | 49 | ||
| 3 Patterns of breathing dysfunction in hyperventilation and breathing pattern disorders | 51 | ||
| Chapter contents | 51 | ||
| Introduction | 51 | ||
| Normal breathing | 51 | ||
| Rates and volumes | 52 | ||
| Definition of HVS | 52 | ||
| Organic causes of increased breathing | 52 | ||
| Etiological breathing pattern disorder factors | 53 | ||
| Psychological factors | 53 | ||
| Biochemical factors | 53 | ||
| Biomechanical factors | 53 | ||
| Other factors | 53 | ||
| Acute hyperventilation | 53 | ||
| Neurological signs | 53 | ||
| Metabolic disturbances | 53 | ||
| Cardiac signs | 54 | ||
| Gastrointestinal signs | 54 | ||
| Chronic hyperventilation | 54 | ||
| Diagnosis | 55 | ||
| Breathing pattern disorders secondary to other health problems | 57 | ||
| Obstructive disorders | 57 | ||
| Restrictive disorders | 57 | ||
| Breathing patterns | 58 | ||
| Pre- and post-surgical breathing problems | 58 | ||
| Conclusion | 58 | ||
| References | 58 | ||
| 4 Biochemical aspects of breathing | 61 | ||
| Chapter contents | 61 | ||
| The biochemistry of breathing | 61 | ||
| pH | 62 | ||
| Carbon dioxide | 62 | ||
| Metabolic alkalosis and acidosis | 63 | ||
| Bicarbonate buffer (Fig. 4.3) | 64 | ||
| Oxygen transport and delivery | 65 | ||
| Psychogenic hyperventilation | 66 | ||
| Cerebral blood flow | 66 | ||
| The biochemistry of anxiety and activity | 66 | ||
| Unstable breathing | 67 | ||
| Neural regulation of breathing | 68 | ||
| Persistence of hyperventilation | 68 | ||
| Panic attacks during relaxation | 68 | ||
| General summary | 69 | ||
| Allergic, dietary and nutritional factors | 69 | ||
| Mechanisms | 70 | ||
| Mast cells | 70 | ||
| Strategies | 72 | ||
| Summary | 72 | ||
| Dietary links to anxiety, panic attacks and phobic behaviour | 73 | ||
| The blood-glucose–hyperventilation connection | 74 | ||
| The progesterone–hyperventilation connection | 74 | ||
| Exercise and biochemistry | 75 | ||
| References | 75 | ||
| 5 Interaction of psychological and emotional variables with breathing dysfunction | 79 | ||
| Chapter contents | 79 | ||
| The diaphragm and the phrenic nerve | 79 | ||
| Emotional disruption of optimal breathing | 80 | ||
| Depth and rate of breathing | 81 | ||
| Breath-holding | 81 | ||
| Location of breathing | 81 | ||
| Chest vs. abdomen | 81 | ||
| Reasons for chest breathing | 81 | ||
| Action projection | 82 | ||
| Action projection and accessory breathing muscles | 82 | ||
| Nose breathing vs. mouth breathing | 83 | ||
| Conditioned breathing responses | 84 | ||
| Experimental conditioning of breathing changes | 85 | ||
| Fear conditioning and the amygdala | 86 | ||
| Incidental learning | 87 | ||
| Hypnotic investigations | 87 | ||
| Dissociation | 89 | ||
| Hyperventilation-related cognitive and performance deficits | 89 | ||
| Conclusions | 90 | ||
| References | 91 | ||
| 6.1 Dynamic Neuromuscular Stabilization: | 93 | ||
| Chapter contents | 93 | ||
| DNS: clinical examination of dual respiratory-postural function | 93 | ||
| Standing posture assessment | 93 | ||
| Assessment of the breathing pattern and the diaphragm’s respiratory function | 96 | ||
| Assessment of the diaphragm’s postural function | 97 | ||
| References | 98 | ||
| 6.2 Osteopathic assessment of structural changes related to BPD | 99 | ||
| Chapter contents | 99 | ||
| Structure–function | 100 | ||
| Functional symmetry | 100 | ||
| Functional assessment approaches | 100 | ||
| Osteopathic assessment | 101 | ||
| A. Seated: the HiLo or ‘two-hand’ test (Fig. 6.2.1) | 101 | ||
| B. Palpation for symmetry of motion on inhalation | 101 | ||
| C. 1st rib palpation test (Fig. 6.2.2) | 101 | ||
| D. Seated assessment of lateral expansion (Fig. 6.2.3) | 103 | ||
| E. Supine rib palpation test: ribs 2–10 (Fig. 6.2.4) | 103 | ||
| F. Assessment of lower thorax/thoracolumbar restriction | 104 | ||
| Supine assessment of breathing pattern | 104 | ||
| G. Rib palpation test: ribs 11 and 12 (Fig. 6.2.7) | 105 | ||
| H. Hip abduction test (Fig. 6.2.8) | 105 | ||
| I. Hip extension test | 106 | ||
| J. Scapulohumeral rhythm test | 106 | ||
| Variation 1 | 106 | ||
| K. Spring test for upper thoracic spine (Beal 1983) (Fig. 6.2.10) | 106 | ||
| L. The ‘breathing wave’ (Fig. 6.2.11) | 108 | ||
| Assessment of shortness in accessory (and obligatory) breathing muscles | 109 | ||
| Barrier terminology | 109 | ||
| Not every shortened muscle requires attention | 109 | ||
| Assessment for shortness of iliopsoas (Fig. 6.2.12) | 110 | ||
| Assessment for shortness of quadratus lumborum (Fig. 6.2.13) | 110 | ||
| Assessment for shortness in pectoralis major (Fig. 6.2.14) | 111 | ||
| Assessment for shortness of upper trapezius (Fig. 6.2.15) | 111 | ||
| Assessment for shortness in scalenes | 111 | ||
| Assessment for shortness of sternocleidomastoid | 112 | ||
| Myofascial trigger points: relevance and assessment | 112 | ||
| Relevance of trigger points in breathing pattern disorder | 112 | ||
| Identifying MTrPs | 113 | ||
| Diagnostic features of MTrPs (Simons et al 1998, Simons 2002, Simons 2004) | 114 | ||
| Conclusion | 115 | ||
| References | 116 | ||
| 6.3 Physiotherapy assessment approaches | 119 | ||
| Chapter contents | 119 | ||
| Physiotherapy assessment | 119 | ||
| The environment | 120 | ||
| Physiotherapy assessment | 120 | ||
| Detailed history | 120 | ||
| Past medical history | 120 | ||
| Social history | 121 | ||
| History of tests/investigations | 121 | ||
| Alternative therapies | 121 | ||
| Questionnaires | 121 | ||
| Nijmegen Questionnaire | 121 | ||
| The Rowley Breathing (RoBE) Self-Efficacy Scale | 121 | ||
| The Hospital Anxiety and Depression (HAD) Questionnaire (Zigmond & Snaith 1983) | 121 | ||
| Clinical observation of rate and patterns of breathing | 122 | ||
| Nasal problems (see also Ch. 2.3) | 122 | ||
| Obstruction | 122 | ||
| Snoring | 122 | ||
| Seasonal rhinitis | 122 | ||
| Mouth breathing | 122 | ||
| Breath-hold tests | 122 | ||
| Musculoskeletal inspection/observation | 122 | ||
| Adaptive upper thoracic and shoulder-girdle muscle changes | 123 | ||
| Oximetry | 125 | ||
| Capnography (see also Ch. 7.7) | 126 | ||
| Peak expiratory flow rate (PEFR) | 126 | ||
| Education | 126 | ||
| References | 127 | ||
| 6.4 Psychological assessment of breathing problems | 129 | ||
| Chapter contents | 129 | ||
| Physiological monitoring of the breathing pattern | 129 | ||
| The anxiety sensitivity index | 132 | ||
| Respiratory sinus arrhythmia (RSA) | 133 | ||
| Psychophysiological monitoring | 133 | ||
| Hyperventilation provocation test | 134 | ||
| References | 136 | ||
| 6.5 Questionnaires and manual methods for assessing breathing dysfunction | 137 | ||
| Chapter contents | 137 | ||
| Introduction | 137 | ||
| Questionnaires | 138 | ||
| The Nijmegen Questionnaire (NQ) (see Appendix 1, at end of this chapter) | 138 | ||
| Normal and abnormal values | 138 | ||
| Distress and respiratory distress | 139 | ||
| Responsive to treatment | 139 | ||
| Sub scores | 139 | ||
| The Self-Evaluation of Breathing Questionnaire (SEBQ) (see Appendix 2 at end of this chapter) | 140 | ||
| Comparing the SEBQ and the NQ | 140 | ||
| Practical uses of the SEBQ | 141 | ||
| Manual techniques for evaluating breathing pattern | 141 | ||
| The Manual Assessment of Respiratory Movement (MARM) | 141 | ||
| Performing the MARM | 141 | ||
| Recording the MARM | 141 | ||
| Calculating MARM variables | 142 | ||
| The MARM and balanced breathing | 143 | ||
| Using the MARM to assess functionality of breathing | 143 | ||
| MARM testing protocol and normal values | 143 | ||
| Using the MARM to assess other aspects of breathing | 143 | ||
| Conclusion | 143 | ||
| References | 144 | ||
| Appendix 1 The Nijmegen Questionnaire | 145 | ||
| Appendix 2 The Self-Evaluation of Breathing Questionnaire | 146 | ||
| 6.6 Capnography assessment | 147 | ||
| Chapter contents | 147 | ||
| Capnography basics | 147 | ||
| Clinical setting | 148 | ||
| Capnography testing | 149 | ||
| Screen interpretation: normal/examples of abnormal (Figs 6.6.2 to 6.6.6) | 149 | ||
| Examples of poor pattern | 149 | ||
| Standardized tests | 149 | ||
| Test interpretation | 151 | ||
| Customized testing | 151 | ||
| Think test (Case study 6.6.1) | 151 | ||
| Intentional overbreathing | 151 | ||
| In sport and fitness | 152 | ||
| Anaerobic testing protocol (Litchfield 2012) | 152 | ||
| Interpretation | 152 | ||
| Conclusion | 152 | ||
| References | 153 | ||
| 7.1a Indirect approaches to breathing regulation | 155 | ||
| Chapter contents | 155 | ||
| Introduction | 155 | ||
| Systems view | 156 | ||
| Rationale of indirect regulation | 157 | ||
| Practical example of indirect instructions in the sitting position | 157 | ||
| Sitting position | 157 | ||
| Option: position of feet | 157 | ||
| Step 1. Move forward and backward | 158 | ||
| Step 2. Stay front/back and breathe | 158 | ||
| Step 3. Move forward/backward and lumbar spine (Fig. 7.1a.2) | 158 | ||
| Step 4. Coupling forward/backward to breathing | 159 | ||
| Option: opening and closing the knees | 159 | ||
| Option: holding the head | 160 | ||
| Discussion: a personal perspective | 160 | ||
| References | 161 | ||
| 7.1b Dynamic Neuromuscular Stabilization: | 163 | ||
| Chapter contents | 163 | ||
| Introduction | 163 | ||
| Treatment techniques to optimize a postural respiratory pattern | 164 | ||
| Influencing hypomobility and dynamics of the thoracic wall | 164 | ||
| Influencing spine straightening | 165 | ||
| Activation of an optimal respiratory stabilization pattern through reflex locomotion | 165 | ||
| Practising a postural breathing pattern and the stabilization function of the diaphragm | 166 | ||
| Practising postural stabilization of the spine in the positions related to developmental sequences – modified positions and versions | 166 | ||
| Respiratory pattern correction. | 166 | ||
| Postural activation of the diaphragm – practice of intra-abdominal pressure control. | 166 | ||
| Conclusion | 167 | ||
| Acknowledgments | 167 | ||
| References | 167 | ||
| 7.2 Osteopathic treatment of thoracic and respiratory dysfunction | 169 | ||
| Chapter contents | 169 | ||
| Normalizing muscular and joint restrictions | 170 | ||
| Muscle energy technique (MET) procedures | 170 | ||
| MET methodology | 170 | ||
| Mechanisms | 170 | ||
| Respiratory and visual synkinesis | 170 | ||
| Additional MET variations | 170 | ||
| Ruddy’s ‘pulsed MET’ | 170 | ||
| MET of selected accessory and obligatory respiratory muscles | 171 | ||
| MET treatment of psoas (Fig. 7.2.1) | 171 | ||
| MET for shortness in quadratus lumborum (QL) (Fig. 7.2.2) | 171 | ||
| MET treatment of pectoralis major (Fig. 7.2.3) | 171 | ||
| MET treatment of shortened upper trapezius (Fig. 7.2.4A–C) | 172 | ||
| Treatment details | 172 | ||
| MET treatment of short scalenes (Fig. 7.2.5A–C) | 173 | ||
| MET treatment of shortened sternocleidomastoid (Fig. 7.2.5A) | 173 | ||
| MET for joint restrictions | 174 | ||
| Evaluating and treating thoracic spinal restrictions using MET (Seffinger & Hruby 2007) (Figs 7.2.6A and B) | 174 | ||
| General principles of MET for rib dysfunction | 175 | ||
| MET treatment for restricted (elevated or depressed) 1st rib (Fig. 7.2.7) | 175 | ||
| MET treatment for restricted 2nd to 10th ribs | 176 | ||
| For elevated ribs (restricted in inhalation position) (Fig. 7.2.8) | 176 | ||
| For depressed ribs (restricted in exhalation position) (Fig. 7.2.9A&B) | 176 | ||
| Lower thoracic cage release (diaphragm attachments) using MET | 177 | ||
| Positional release techniques | 177 | ||
| Strain/counterstrain | 177 | ||
| Common basis | 177 | ||
| Method | 178 | ||
| Strain/counterstrain (SCS) guidelines (Wong 2012, Chaitow 2007) | 178 | ||
| Strain/counterstrain for interspace dysfunction | 178 | ||
| Deactivating myofascial trigger points | 179 | ||
| Variations | 179 | ||
| Integrated neuromuscular inhibition technique (Chaitow 1994, Chaitow & DeLany 2008, Nagrale 2010) (Fig. 7.2.12) | 179 | ||
| Enhancing respiratory function with adjunctive osteopathic manipulative methods | 179 | ||
| 1. Thoracic lymphatic pump technique | 179 | ||
| Method | 180 | ||
| 2. Rib raising | 180 | ||
| Conclusion (Box 7.2.1) | 181 | ||
| References | 182 | ||
| 7.3 Physiotherapy in rehabilitation of breathing pattern disorders | 185 | ||
| Chapter contents | 185 | ||
| Breathing retraining | 185 | ||
| Follow-up | 187 | ||
| Sniff test seated (Box 7.3.2) | 187 | ||
| Standing | 189 | ||
| Common coexisting problems | 189 | ||
| Asthma and chronic obstructive pulmonary disease (COPD) | 189 | ||
| Chronic rhino sinusitis (CRS) | 189 | ||
| Chronic pain | 190 | ||
| Hormonal influences | 190 | ||
| Self-confidence | 190 | ||
| Total body relaxation | 190 | ||
| Speech | 191 | ||
| Exercise | 192 | ||
| Establishing an exercise programme | 193 | ||
| Rest and sleep | 194 | ||
| A vicious cycle is established | 194 | ||
| Re-establishing normal sleep patterns | 194 | ||
| Sleep hygiene checklist | 195 | ||
| Sleep retraining | 195 | ||
| Toward independence | 195 | ||
| Creating an individual programme | 195 | ||
| References | 195 | ||
| 7.4 Psychological training and treatment of breathing problems | 197 | ||
| Chapter contents | 197 | ||
| Self-mastery | 198 | ||
| Hyperventilation | 198 | ||
| Pausing the breath | 198 | ||
| Alleviating acute hyperventilation | 199 | ||
| ‘False equilibrium’ and adaptation to imbalance | 199 | ||
| Using a capnometer | 199 | ||
| Checking for presence of hyperventilation | 200 | ||
| Demonstrating the effects of emotional recall | 200 | ||
| Cognitive therapy | 200 | ||
| Panic disorder | 201 | ||
| Cardiac rehabilitation | 202 | ||
| References | 202 | ||
| 7.5 Speech and singing | 203 | ||
| Chapter contents | 203 | ||
| How breathing disorders affect the voice | 204 | ||
| Poor breathing coordination and phonation | 204 | ||
| The larynx | 205 | ||
| Posture and hypertonicity | 205 | ||
| The diaphragm | 206 | ||
| The abdominal and pelvic floor muscles | 206 | ||
| Taking a history | 207 | ||
| Assessment | 208 | ||
| Observation | 208 | ||
| Palpation | 209 | ||
| Dynamic ultrasound equipment | 210 | ||
| Treatment | 210 | ||
| Breath control in phonation | 210 | ||
| Motor learning theory in breathing and vocal dysfunction treatment | 210 | ||
| Musculoskeletal manual therapy and voice retraining | 211 | ||
| Expiratory muscle training | 211 | ||
| Conclusion | 211 | ||
| References | 213 | ||
| 7.6 Breathing pattern disorders and the athlete | 215 | ||
| Chapter contents | 215 | ||
| Introduction | 215 | ||
| Breathing pattern disorders | 215 | ||
| Biomechanical | 216 | ||
| Physiological/biochemical | 216 | ||
| Emotional/psychological | 216 | ||
| Biomechanical considerations | 216 | ||
| Pressure control: biomechanics | 216 | ||
| Pressure control: muscle length tension relationship | 216 | ||
| Muscle recruitment/motor patterns | 217 | ||
| Breathing entrainment | 217 | ||
| Dynamic hyperinflation | 218 | ||
| Physiological considerations | 218 | ||
| Hyperventilation | 218 | ||
| ‘Blood stealing’ | 218 | ||
| Hypoxic training | 219 | ||
| Psychological/emotional considerations | 219 | ||
| Guidelines for clinical implementation | 221 | ||
| Assessment indicators for the athlete | 221 | ||
| Breathlessness experienced during sport/activity | 221 | ||
| Objective considerations | 221 | ||
| BradCliff® Ski Jump Test (Fig. 7.6.3) | 221 | ||
| Lying in supine with knees bent | 221 | ||
| BradCliff® Angle Test (Xyphocostal border) (Fig. 7.6.4) | 221 | ||
| Lying in supine | 221 | ||
| Dynamic observations | 222 | ||
| Treatment protocols for the athlete/sports individual | 223 | ||
| Breathing re-education for rest and recovery | 223 | ||
| Prior to sport | 223 | ||
| Sport specific | 223 | ||
| Resistance training of the breathing muscles | 223 | ||
| Conclusion | 223 | ||
| References | 224 | ||
| 7.7 Capnography in treatment of BPD | 225 | ||
| Chapter contents | 225 | ||
| General concepts | 225 | ||
| Self-discovery/awareness training | 225 | ||
| Wave play | 226 | ||
| Rate/ratio retraining | 226 | ||
| Negative play | 227 | ||
| Context retraining | 227 | ||
| Intentional overbreathing | 227 | ||
| High performance and sport | 229 | ||
| Common clinical presentations | 229 | ||
| Breathing too fast | 229 | ||
| Too much volume | 230 | ||
| Poor rate, pattern and ETCO2 | 230 | ||
| Dissociative overbreathing | 231 | ||
| Conclusion | 231 | ||
| References | 232 | ||
| 8.1 Breathing patterns in longstanding pain disorders: | 233 | ||
| Chapter contents | 233 | ||
| Abstract | 233 | ||
| Background | 233 | ||
| Theory | 234 | ||
| Somatocognitive therapy | 235 | ||
| Development of a Standardized Mensendieck Test (SMT) | 236 | ||
| Breathing | 236 | ||
| Elements used in breathing therapy in a somatocognitive session | 236 | ||
| Some results from studies using somatocognitive therapy in populations of pain patients | 238 | ||
| Conclusion | 239 | ||
| References | 239 | ||
| 8.2 Buteyko breathing method | 241 | ||
| Chapter contents | 241 | ||
| What is the Buteyko Method? | 241 | ||
| Research studies on the effectiveness of the Buteyko Method | 241 | ||
| Techniques of the Buteyko Method | 241 | ||
| Reduced-volume breathing | 242 | ||
| Breath slowing | 242 | ||
| Breath-holding techniques | 243 | ||
| Establishing nasal breathing | 243 | ||
| Dr Buteyko’s carbon dioxide theory | 243 | ||
| Importance of CO2 in human health | 244 | ||
| Prevalence of chronic hypocapnia | 244 | ||
| Relationship between hypocapnia and symptoms | 244 | ||
| Disease as a defence mechanism against loss of CO2 | 244 | ||
| Do improvements in CO2 sufficiently explain the Buteyko effect? | 245 | ||
| Is a more comprehensive theory for the Buteyko Method more useful? | 245 | ||
| Psychophysiological factors | 245 | ||
| Future directions for the Buteyko Method | 246 | ||
| References | 246 | ||
| 8.3 Feldenkrais® and breathing | 249 | ||
| Chapter contents | 249 | ||
| Introduction | 249 | ||
| Embodiment | 250 | ||
| Interoception | 251 | ||
| Contours of breathing | 251 | ||
| Student experiences | 254 | ||
| Manual therapy | 255 | ||
| Conclusions | 257 | ||
| Acknowledgments | 257 | ||
| Disclaimer | 257 | ||
| References | 258 | ||
| 8.4 Pilates in the rehabilitation of breathing disorders | 259 | ||
| Chapter contents | 259 | ||
| A Pilates teacher’s skill set | 260 | ||
| Pilates’ writings and principles | 260 | ||
| Pilates: a system, an art, not yet truly a science | 260 | ||
| Joseph pilates on breath | 260 | ||
| The mechanics of breathing in Pilates | 260 | ||
| Teaching Pilates laterocostal breathing | 261 | ||
| Pilates laterocostal breathing – client facilitated | 262 | ||
| Pilates laterocostal breathing and centre | 263 | ||
| Standing latissimus press (‘lat press’) | 263 | ||
| Variation in Pilates breathing: the four breath and two breath pattern, percussive breathing | 263 | ||
| Movement direction and Pilates breathing patterns | 264 | ||
| Applicationv in teaching – remedial contexts | 265 | ||
| Breathing and stability | 265 | ||
| The future | 266 | ||
| References | 266 | ||
| 8.5 Tai chi, Qigong and breathing | 267 | ||
| Chapter contents | 267 | ||
| Overview of qigong and tai chi | 267 | ||
| Theoretical basis of Qi | 267 | ||
| Tai chi Qigong (TCQ) | 268 | ||
| Body training and breathing training by TCQ | 268 | ||
| Health benefits of TCQ | 268 | ||
| Balance and fall prevention | 268 | ||
| Cardiopulmonary function | 268 | ||
| Physical function | 268 | ||
| Psychological health | 268 | ||
| Quality of life (QOL) | 268 | ||
| Benefits of TCQ on respiratory functions | 269 | ||
| Concerns for conducting a TCQ study for people with breathing difficulties | 269 | ||
| The TCQ programme for people with breathing difficulties | 269 | ||
| Experimental protocol of TCQ programme | 270 | ||
| Mode of delivery of the TCQ training | 270 | ||
| The 13 movements of breathing regulating TCQ (Fig. 8.5.1 and Box 8.5.1) | 271 | ||
| Skills mastery of the participants | 271 | ||
| TCQ programme evaluation | 271 | ||
| Effects of TCQ on people with respiratory dysfunction | 272 | ||
| Summary | 272 | ||
| References | 273 | ||
| 8.6 A review of the use of yoga in breathing disorders | 275 | ||
| Chapter contents | 275 | ||
| Yoga: definitions, yoga as a lifestyle, and practices traditionally included | 275 | ||
| Types of yoga, descriptions from traditional texts and contemporary knowledge | 276 | ||
| Importance of respiration in yoga and the yoga theory of disease | 276 | ||
| Yoga breathing or pranayama, definition and types | 277 | ||
| The method of practising different pranayamas, precautions and contraindications | 277 | ||
| Pranayama (or yoga breathing) practices involving changes in breath rate | 277 | ||
| Pranayama involving changes in which nostril (left, right, or alternate) is breathed through | 277 | ||
| Pranayama involving exhalation during which a sound is produced | 278 | ||
| Pranayama involving increasing the depth of breathing | 278 | ||
| Pranayama with breath holding | 278 | ||
| Pranayama techniques: breathing in through the mouth | 278 | ||
| Physiological effects of the pranayamas (Fig. 8.6.2) | 279 | ||
| Pranayama practices involving changes in breath rate | 279 | ||
| Pranayama involving changes in which nostril is breathed through | 279 | ||
| Pranayama involving exhalation during which a sound is produced | 280 | ||
| Pranayama involving increasing the depth of breathing | 280 | ||
| Pranayamas which involve inhalation through the mouth | 280 | ||
| Applications of the different pranayama practices in health and other dimensions of life | 280 | ||
| Studies of yoga as therapy | 281 | ||
| Mechanisms underlying the effects | 281 | ||
| References | 281 | ||
| 9 Self-help approaches | 283 | ||
| Chapter contents | 283 | ||
| Introduction | 283 | ||
| Stress scan | 284 | ||
| Anti-arousal breathing exercise | 284 | ||
| Reducing shoulder movement during breathing (Fig. 9.1) | 284 | ||
| Brugger’s relief position (Fig. 9.2) | 285 | ||
| Autogenic training relaxation | 286 | ||
| Exercise for effective relaxation | 286 | ||
| Explanation | 286 | ||
| How to use these skills for health enhancement by visualizing change | 286 | ||
| Self-efficacy questionnaire | 287 | ||
| RoBE Scale | 287 | ||
| RoBE Scale information for practitioners | 287 | ||
| Rowley breathing pattern disorders self-efficacy scale | 287 | ||
| Why self-efficacy? | 287 | ||
| Clinical application of the RoBE | 287 | ||
| Question 1: confidence doing daily tasks without being affected by symptoms | 288 | ||
| Question 2: talk without being affected by symptoms | 288 | ||
| Question 3: enjoy recreational activities | 288 | ||
| Question 4: identify triggers | 288 | ||
| Question 5: improve your symptoms with what you do | 288 | ||
| Question 6: manage your symptoms without introducing medication | 288 | ||
| Question 7: go into situations that might bring on symptoms | 288 | ||
| Question 8: make useful improvements by improving breathing | 288 | ||
| Question 9: persist at improving breathing pattern | 288 | ||
| Four key factors that enhance self-efficacy | 288 | ||
| Useful reading | 289 | ||
| Nasal saline irrigation – instructions for patients | 289 | ||
| Use | 289 | ||
| Xylitol nasal spray recipe | 289 | ||
| Mixing the spray | 289 | ||
| Using the spray | 289 | ||
| Reference | 289 | ||
| Recommendations for hyperventilation | 290 | ||
| Factors involved in hyperventilation | 290 | ||
| Faults in hyperventilation and corrective exercises | 291 | ||
| Diaphragm exercises | 291 | ||
| Practise sessions | 291 | ||
| Standing practise | 291 | ||
| Periodic reminders | 292 | ||
| Cultivate relaxation at all times | 292 | ||
| Walking rhythm | 292 | ||
| Walking to eliminate body tension | 292 | ||
| Index | 293 | ||
| A | 293 | ||
| B | 293 | ||
| C | 294 | ||
| D | 294 | ||
| E | 295 | ||
| F | 295 | ||
| G | 295 | ||
| H | 295 | ||
| I | 296 | ||
| J | 296 | ||
| K | 296 | ||
| L | 296 | ||
| M | 296 | ||
| N | 296 | ||
| O | 297 | ||
| P | 297 | ||
| Q | 298 | ||
| R | 298 | ||
| S | 298 | ||
| T | 298 | ||
| U | 299 | ||
| V | 299 | ||
| W | 299 | ||
| X | 299 | ||
| Y | 299 | ||
| Z | 299 |